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Despite $600 million in federal dollars allocated to creating health information exchanges designed to facilitate sharing of patient medical information, more work needs to be done to show whether they are living up to their promise, a new RAND Corp. study indicates.

RAND researchers say there is a small amount of information showing that health information exchanges are reducing emergency department costs thanks to information sharing, but that’s about it. There lacks data and evaluations on most of the more than 100 health information exchanges that have been created across the country, RAND researchers said.

“We want to know what is working and what isn’t working,” Robert Rudin, the lead author of the study, published in the Dec. 2 issue of the Annals of Internal Medicine, said in an interview this afternoon with Forbes. “We want to know what’s working so we can take all of those lessons and apply them across the country.”

The creation health information exchanges comes from two laws signed into law by President Obama. In 2009, Obama signed into law the Health Information Technology for Economic and Clinical Health Act, (HITECH) which was part of the federal stimulus legislation known as the American Reinvestment and Recovery Act.

The legislation provides more than $20 billion to help doctors and hospitals move into the digital age through the use of electronic health records and related health information technology. The $600 million designed to support statewide health information exchange organizations was part of that amount, according to the legislation, and supporters say such organizations were desperately needed for the highly fragmented U.S. health care system to communicate more effectively in order to provide higher quality and more cost-effective medical care service.

“Our review found that, despite this enormous investment, the use of health information exchanges has only been studied in a few emergency departments,” Rudin said in a statement accompanying RAND researchers 10-page review in the Annals of Internal Medicine. “In those studies, it seems to have some beneficial effect. Outside of that, there just aren’t enough studies to indicate whether or not they are having the beneficial effects intended.”

By not evaluating the exchanges, those involved are missing opportunities, RAND researchers said.

“Every HIE (health information exchange) should have an evaluation plan,” Rudin said in an interview. “That might mean partnering with an external research organization and having a more formal evaluation to see the extent of use and the impact on patient health outcomes and quality.”

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